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https://www.readbyqxmd.com/read/29471453/modified-minimally-invasive-transforaminal-lumbar-interbody-fusion-technique-can-potentially-improve-safety-of-interbody-graft-placement
#1
Khalid H Kurtom, Wendy S Towers
BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (MITLIF) is a well-described procedure with excellent reported outcomes. A modification of interbody graft placement can potentially improve the ease and safety of this procedure. OBJECTIVE: To describe a modification of the MITLIF graft placement and retrospectively review our experience including intraoperative and postoperative complications. METHODS: Single surgeon, single institution, retrospective analysis of consecutive patients who underwent a modified MITLIF technique between November 2011 and December 2013...
February 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29462736/use-of-a-pediatric-craniotome-drill-for-cervical-and-thoracic-spine-decompression-safety-and-efficacy
#2
Christopher Elia, Omid R Hariri, Jason Duong, Fanglong Dong, Raed Sweiss, Dan Miulli
INTRODUCTION: Laminectomy utilizing a high-speed drill with an unprotected cutting drill bit can be rapid and effective, but it has been associated with known complications. Another technique utilizes a pediatric craniotome drill with the footplate attachment. Currently, there are no studies comparing clinical outcomes between these two stated decompressive techniques. METHODS: A retrospective review was conducted at a single institution. Two cohorts of patients were considered based on the technical method of laminectomy for decompression...
February 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29393808/imaging-and-surgical-approach-to-a-pediatric-penetrating-intradural-wooden-splinter-case-report
#3
Gabrielle Santangelo, Jonathan Stone, Tyler Schmidt, G Edward Vates, Howard Silberstein, Pierre Girgis
Penetrating spinal injuries by wood are infrequently reported. They are particularly rare in children. Only 6 cases of wooden fragments causing penetrating intradural spinal injury have been reported. The authors report a case of a 3-year-old girl who suffered a penetrating wound on her lower back after sliding on a wood floor. A portion of the extraspinal part of the wooden splinter was removed prior to presentation; however, a high suspicion for retained foreign body was maintained. Findings on CT were equivocal, but the diagnosis was confirmed on MRI...
February 2, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29346684/comparing-cortical-trajectory-transforaminal-lumbar-interbody-fusions-against-pedicle-trajectory-transforaminal-lumbar-interbody-fusions-and-posterolateral-fusions-a-retrospective-cohort-study-of-90-day-outcomes
#4
James G Malcolm, Michael K Moore, Falgun H Choksh, Faiz U Ahmad, Daniel Refai
BACKGROUND: The cortical screw (CS) trajectory for pedicle screw placement is believed to require a smaller incision and less tissue dissection resulting in lower blood loss and faster healing; however, this has not yet been confirmed in clinical studies. OBJECTIVE: To compare CS transforaminal lumbar interbody fusions (TLIF), traditional pedicle screw (TPS) trajectory TLIFs, and posterolateral fusion (PLF) without interbody for differences in operative characteristics and complications...
January 13, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29303471/comparison-of-percutaneous-endoscopic-transforaminal-discectomy-microendoscopic-discectomy-and-microdiscectomy-for-symptomatic-lumbar-disc-herniation-minimum-2-year-follow-up-results
#5
Xinyu Liu, Suomao Yuan, Yonghao Tian, Lianlei Wang, Liangtai Gong, Yanping Zheng, Jianmin Li
OBJECTIVE This study aimed to evaluate the clinical outcomes of percutaneous endoscopic transforaminal discectomy (PETD), microendoscopic discectomy (MED), and microdiscectomy (MD) for treatment of symptomatic lumbar disc herniation (LDH). METHODS One hundred ninety-two patients with symptomatic LDH at L3-4 and L4-5 were included in this study. The mean (± SD) age of patients was 34.2 ± 2.6 years (range 18-62 years). The patients were divided into groups as follows: group A was treated with PETD and included 60 patients (31 men and 29 women) with a mean age of 36...
January 5, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29300964/piezosurgery-a-safe-technique-to-perform-lateral-suboccipital-craniotomy
#6
Juergen Grauvogel, Waseem Masalha, Dieter Henrik Heiland, Nadja Jarc, Tanja Daniela Grauvogel, Christian Scheiwe
BACKGROUND: Piezosurgery (PS) is a relatively new technique based on microvibrations generated by the piezoelectric effect. It selectively cuts bone tissue and preserves the surrounding soft tissue. OBJECTIVE: To evaluate the use of PS for performing lateral suboccipital craniotomy. METHODS: PS was used to perform a lateral suboccipital craniotomy in 22 patients who underwent surgery for different cerebellopontine angle (CPA) pathologies in the neurosurgical department...
December 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29227037/prospective-transfrontal-sheep-model-of-skull-base-reconstruction-using-vascularized-mucosa
#7
Sarina K Mueller, George Scangas, Mansor M Amiji, Benjamin S Bleier
BACKGROUND: No high-fidelity animal model exists to examine prospective wound healing following vascularized reconstruction of the skull base. Such a model would require the ability to study the prospective behavior of vascularized mucosal repairs of large dural and arachnoid defects within the intranasal environment. The objective of this study was to therefore develop and validate a novel, in vivo, transfrontal sheep model of cranial base repair using vascularized sinonasal mucosa. METHODS: Twelve transfrontal craniotomy and 1...
December 11, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29223327/restoration-of-motor-function-after-operative-reconstruction-of-the-acutely-transected-spinal-cord-in-the-canine-model
#8
Zehan Liu, Shuai Ren, Kuang Fu, Qiong Wu, Jun Wu, Liting Hou, Hong Pan, Linlin Sun, Jian Zhang, Bingjian Wang, Qing Miao, Guiyin Sun, Vincenzo Bonicalzi, Sergio Canavero, Xiaoping Ren
BACKGROUND: Cephalosomatic anastomosis or what has been called a "head transplantation" requires full reconnection of the respective transected ends of the spinal cords. The GEMINI spinal cord fusion protocol has been developed for this reason. Here, we report the first randomized, controlled study of the GEMINI protocol in large animals. METHODS: We conducted a randomized, controlled study of a complete transection of the spinal cord at the level of T10 in dogs at Harbin Medical University, Harbin, China...
December 6, 2017: Surgery
https://www.readbyqxmd.com/read/29200173/medical-malpractice-claims-following-incidental-durotomy-due-to-spinal-surgery
#9
Wesley M Durand, Adam E M Eltorai, Govind Shantharam, J Mason DePasse, Eren O Kuris, Alicia E Hersey, Mark A Palumbo, Alan H Daniels
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Analyze medical malpractice verdicts and settlements associated with incidental durotomy. SUMMARY OF BACKGROUND DATA: Incidental durotomy is a common complication of spine surgery. While most intraoperative dural tears are repaired without sequelae, persistent CSF leak, infection, or neurological injury can yield adverse outcomes. The medicolegal implications of incidental durotomy are poorly understood...
December 4, 2017: Spine
https://www.readbyqxmd.com/read/29190646/risk-factors-for-incidental-durotomy-during-posterior-open-spine-surgery-for-degenerative-diseases-in-adults-a-multicenter-observational-study
#10
Hisatoshi Ishikura, Satoshi Ogihara, Hiroyuki Oka, Toru Maruyama, Hirohiko Inanami, Kota Miyoshi, Ko Matsudaira, Hirotaka Chikuda, Seiichi Azuma, Naohiro Kawamura, Kiyofumi Yamakawa, Nobuhiro Hara, Yasushi Oshima, Jiro Morii, Kazuo Saita, Sakae Tanaka, Takashi Yamazaki
Incidental durotomy (ID) is a common intraoperative complication of spine surgery. It can lead to persistent cerebrospinal fluid leakage, which may cause serious complications, including severe headache, pseudomeningocele formation, nerve root entrapment, and intracranial hemorrhage. As a result, it contributes to higher healthcare costs and poor patient outcomes. The purpose of this study was to clarify the independent risk factors that can cause ID during posterior open spine surgery for degenerative diseases in adults...
2017: PloS One
https://www.readbyqxmd.com/read/29186606/technique-of-minimally-invasive-cervical-foraminotomy
#11
Donald A Ross, Kelly J Bridges
BACKGROUND: Posterior cervical foraminotomy is a long utilized and commonly performed procedure, but has been supplanted in many cases by anterior procedures. With the advent of minimally invasive techniques, posterior foraminotomy may again deserve a prominent place in the treatment of cervical foraminal stenosis. OBJECTIVE: To report in detail a successfully utilized minimally invasive technique and the results in a large series of patients, by a single author...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29176490/incidental-durotomy-in-open-versus-tubular-revision-microdiscectomy-a-retrospective-controlled-study-on-incidence-management-and-outcome
#12
Evangelos Kogias, Jan-Helge Klingler, Pamela Franco Jimenez, Ioannis Vasilikos, Ronen Sircar, Christoph Scholz, Ulrich Hubbe
STUDY DESIGN: Retrospective case-control study. OBJECTIVE: To compare the incidence, management, and outcome of incidental durotomy in revision microdiscectomy with open and minimal-access surgery. SUMMARY OF BACKGROUND DATA: Incidental durotomy occurs with a variable incidence of 3%-27% in spine surgery. The highest rate occurs in revision microdiscectomy. The intraoperative and postoperative management of dural tears varies in the literature and the definite impact on clinical outcome has to be clarified...
December 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29140956/comments-on-legal-implications-incidental-surgical-durotomy
#13
John P Kostuik
No abstract text is available yet for this article.
November 14, 2017: Spine
https://www.readbyqxmd.com/read/29117409/development-of-a-perfusion-based-cadaveric-simulation-model-integrated-into-neurosurgical-training-feasibility-based-on-reconstitution-of-vascular-and-cerebrospinal-fluid-systems
#14
Gabriel Zada, Joshua Bakhsheshian, Martin Pham, Mike Minneti, Eisha Christian, Jesse Winer, Aaron Robison, Bozena Wrobel, Jonathan Russin, William J Mack, Steven Giannotta
BACKGROUND: Novel methodologies providing realistic simulation of the neurosurgical operating room environment are currently needed, particularly for highly subspecialized operations with steep learning curves, high-risk profiles, and demands for advanced psychomotor skills. OBJECTIVE: To describe the development of a curriculum for using perfusion-based cadaveric simulation models in a "Mock Operating Room" for neurosurgical procedures. METHODS: At the USC Keck School of Medicine Fresh Tissue Dissection Laboratory between 2012 and 2016, 43 cadaveric specimens underwent cannulation of the femoral or carotid artery and artificial perfusion of the arterial system, and/or cannulation of the intradural cervical spine for intrathecal reconstitution of the cerebrospinal fluid (CSF) system...
May 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29017307/incarceration-of-spinal-nerve-root-through-incidental-durotomy-as-a-cause-of-sciatica
#15
Young-Jin Kim
Incidental durotomies are a frequent complication during spinal surgery. Cerebrospinal fluid (CSF) leakage from a dural tear may be visually apparent intraoperatively, but occasionally, a tear may not be recognized during the procedure. We report our experience in 2 cases of postoperative incarceration of nerve root as a cause of sciatica, without CSF leakage intraoperatively. When durotomy attributable to surgical manipulation does occur, intraoperative identification is mandated. If a patient develops unexplainable postoperative pain and neurological deficits after lumbar discectomy, incarceration of nerve root should be considered in the differential diagnosis...
September 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28991059/analgesia-nociception-index-monitoring-during-supratentorial-craniotomy
#16
Lakshman K Kommula, Sonia Bansal, Ganne S Umamaheswara Rao
BACKGROUND: Objective monitoring of pain during and after surgery has been elusive. Recently, Analgesia Nociception Index (ANI) monitor based on the high frequency component of heart rate variability has been launched into clinical practice. We monitored analgesia during craniotomy using ANI monitor and compared it with cardiovascular parameters and response entropy (RE) of entropy monitor. MATERIALS AND METHODS: In 21 patients undergoing a craniotomy for a supratentorial lesion, we monitored ANI, heart rate (HR), mean arterial pressure (MAP), state entropy, and RE throughout the surgery...
October 5, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28922957/spinal-meninges-and-their-role-in-spinal-cord-injury-a-neuroanatomical-review
#17
Lukas Grassner, Andreas Grillhösl, Christoph J Griessenauer, Claudius Thomé, Volker Bühren, Martin Strowitzki, Peter A Winkler
Current recommendations support early surgical decompression and blood pressure augmentation after traumatic spinal cord injury (SCI). Elevated intraspinal pressure (ISP), however, has probably been underestimated in the pathophysiology of SCI. Recent studies provide some evidence that ISP measurements and durotomy may be beneficial for individuals suffering from SCI. Compression of the spinal cord against the meninges in SCI patients causes a "compartment-like" syndrome. In such cases, intentional durotomy with augmentative duroplasty to reduce ISP and improve spinal cord perfusion pressure (SCPP) may be indicated...
February 1, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28893299/risk-for-surgical-complications-after-previous-stereotactic-body-radiotherapy-of-the-spine
#18
Johannes Roesch, John B C Cho, Daniel K Fahim, Peter C Gerszten, John C Flickinger, Inga S Grills, Maha Jawad, Ronald Kersh, Daniel Letourneau, Frederick Mantel, Arjun Sahgal, John H Shin, Brian Winey, Matthias Guckenberger
OBJECT: Stereotactic body radiotherapy (SBRT) for vertebral metastases has emerged as a promising technique, offering high rates of symptom relief and local control combined with low risk of toxicity. Nonetheless, local failure or vertebral instability may occur after spine SBRT, generating the need for subsequent surgery in the irradiated region. This study evaluated whether there is an increased incidence of surgical complications in patients previously treated with SBRT at the index level...
September 11, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28863007/intraoperative-neurophysiologic-monitoring-for-prediction-of-postoperative-neurological-improvement-in-a-child-with-chiari-type-i-malformation
#19
Yukari Kawasaki, Susumu Uchida, Kouhei Onishi, Masako Toyokuni, Kazuo Okanari, Minoru Fujiki
INTRODUCTION: Although many surgical treatment strategies for Chiari malformation type I (CM-I) have been reported, the most appropriate surgical technique remains controversial. It is wholly ascribable to the complicacy of pathological condition in CM-I. Recently, intraoperative neurophysiologic monitoring (INM) is becoming prevalent in spinal surgery. Indeed, motor-evoked potentials (MEPs) monitoring and somatosensory-evoked potentials (SSEPs) monitoring are standard tools to minimize the risk of neurologic injury and postoperative deficits...
October 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28857968/risk-factors-and-management-of-incidental-durotomy-in-lumbar-interbody-fusion-surgery
#20
Frederik Enders, Amelie Ackemann, Simon Müller, Karl Kiening, Berk Orakcioglu
STUDY DESIGN: This is a retrospective study analysis. OBJECTIVE: In this retrospective study we evaluated risk factors for incidental durotomy and its impact on the postoperative course. SUMMARY OF BACKGROUND DATA: Lumbar interbody fusion (LIF) is increasingly applied for the treatment of degenerative instability. A known complication is incidental durotomy. MATERIALS AND METHODS: A cohort of 541 patients who underwent primary LIF surgery between 2005 and 2015 was analyzed...
August 28, 2017: Clinical Spine Surgery
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